Cervical mucus anti-sperm antibodies: Treatment with intrauterine insemination

PROBLEM: To determine (1) the incidence of cervical mucus anti-sperm antibodies in infertile women, and (2) the results of treatment by intrauterine insemination. METHOD: Cervical mucus was collected the morning after urinary LH surge occurred from 153 consecutive women being treated for unexplained infertility with intrauterine insemination. Immunobead testing for IgG, IgA, IgA1, and IgA2 was performed with only actively motile sperm being counted. RESULTS: Overall, 23/153 (15.0%) of cervical mucus samples were positive for anti-sperm antibodies: 9/23 (39.1%) were only IgA-positive (62% IgA1-positive, 38% IgA2-positive), 11/23 (47.8%) were only IgG-positive, and 3/23 (13.0%) were positive for both IgA and IgG. Insemination resulted in a pregnancy in 6/23 (26.1%) of women with cervical mucus anti-sperm antibodies after 1-3 cycles. CONCLUSIONS: Testing for cervical mucus anti-sperm antibodies should be performed in cases of 'unexplained' infertility, and intrauterine insemination may be an effective treatment, resulting in pregnancies in over one-fourth of couples.